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Nevada State Office of Rural Health 171

Nevada Rural and Frontier Health Data Book

Section Six: Health Care Resources and Economics in Rural and Frontier Nevada

This section of the Nevada Rural and Frontier Health Data Book – Eighth Edition provides a wide range of current data on health care resources, finances, and utilization by county and region in Nevada. For additional data and trends over time, please visit the Nevada Instant Atlas at www.med.unr.edu/atlas.

Highlights and key findings of this section include:

• Currently, there are 14 rural and frontier hospitals in Nevada serving an estimated population of 281,019 residents scattered over 95,431 square miles — 13 of these facilities are federally designated Critical Access Hospitals (CAHs) (Table 6.1).

• On average, Nevada’s 14 rural and frontier hospitals are 59.1 miles from the nearest hospital and 118.1 miles from the nearest tertiary care hospital (Table 6.1 and Map 6.1).

• Currently, there are 5,322 licensed community hospital beds in Nevada, including 231 licensed community hospital beds in rural and frontier counties (Tables 6.2 and 6.3).

• Currently, there are 1.8 licensed community hospital beds per 1,000 population in Nevada — there are 0.8 licensed community hospital beds per 1,000 population in rural and frontier counties, as compared to a rate of 1.9 in urban counties (Table 6.3).

• There are 5,185 licensed skilled nursing beds in Nevada, including 578 licensed skilled nursing beds in rural and frontier counties (Table 6.3).

• Currently, there are 1.6 licensed skilled nursing beds per 1,000 population in Nevada — there are 2.0 licensed skilled nursing beds per 1,000 population in rural and frontier counties, as compared to a rate of 1.8 in urban counties (Table 6.3).

• In 2015, Nevada’s 14 rural and frontier hospitals had a combined 2,249 employees (FTE) and payroll of $141.0 million — these hospitals had an average annual salary of $62,655 (Table 6.4).

• In 2015, Nevada’s 19 urban acute care hospitals had a combined 23,467 employees (FTE) and payroll of $1.75 billion — urban hospitals had an average annual salary of $74,463 (Table 6.5).

• Nevada’s 14 rural and frontier hospitals employed 2,249 individuals in 2015 — when the jobs created in other businesses as a result of hospital operating activity are included in the analysis rural and frontier hospitals were responsible for an additional 1,222 jobs for a total employment impact of 3,471 jobs (Table 6.6).

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http://www.med.unr.edu/atlas

Nevada Rural and Frontier Health Data Book — Eighth Edition

172 Nevada State Office of Rural Health

• In fiscal year 2015, Nevada’s 19 urban hospitals employed 23,468 individuals — when the jobs created in other businesses as a result of hospital operating activity, are included in the analysis urban hospitals were responsible for an additional 22,093 jobs for a total employment impact of 45,561 jobs (Table 6.6).

• Nevada’s 14 rural and frontier hospitals had a combined payroll of $141.0 million in 2015 — when the income created in other businesses as a result of hospital operating activity is included in the analysis, rural and frontier hospitals were responsible for an additional $34.8 million in personal income for a total payroll impact of $175.7 million (Table 6.7).

• In 2015, Nevada’s 19 urban hospitals had a combined payroll of $1.75 billion — when the income created in other businesses as a result of hospital operating activity is included in the analysis, urban hospitals were responsible for an additional $861.0 million in personal income for a total payroll impact of $2.6 billion (Table 6.7).

• In 2016, there were 108,480 Nevadans employed in the health sector with a combined payroll of $6.6 billion, including 6,640 rural and frontier residents with a combined payroll of $304 million (Tables 6.8 and 6.9).

• Businesses in Nevada’s health sector employed 108,480 in 2016 — when the jobs created in other non-health sector businesses as a result of health sector operating activity are included in the analysis, Nevada’s health sector was responsible for an additional 71,676 jobs for a total employment impact of 180,156 jobs (Table 6.8).

• In 2016, businesses in the health sector in rural and frontier counties of Nevada employed 6,640 individuals — when the jobs created in other non-health sector businesses as a result of health sector operating activity are included in the analysis, the rural health sector was responsible for an additional 2,236 jobs for a total employment impact of 8,929 jobs (Table 6.8).

• Businesses in Nevada’s health sector had a combined payroll of $6.5 billion in 2016 — when the income created in other non-health sector businesses as a result of health sector operating activity is included in the analysis, Nevada’s health sector was responsible for an additional $2.8 billion in personal income for a total payroll impact of $9.4 billion (Table 6.9).

• In 2016, businesses in the health sector in rural and frontier counties of Nevada had a combined payroll of $304.0 million — when the income created in other non-health sector businesses as a result of health sector operating activity is included in the analysis, the rural health sector was responsible for an additional $63.4 million in personal income for a total payroll impact of $368.1 million (Table 6.9).

• Currently, of the 14 rural and frontier hospitals in Nevada, six are not-for-profit (publicly owned) hospitals, four not-for-profit (privately owned) hospitals, and three for-profit (privately owned) hospitals, and one not-for-profit (non-governmental) hospital (Table 6.10).

• In 2017, there are eight rural and frontier community hospitals with provider-based rural health clinics (RHCs). There are also nine non-hospital based Federally Qualified Health Clinics (FQHCs), and 13 tribal and Indian Health Service (IHS) clinics and health centers (Tables 6.10 through 6.12).

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• In 2015, Nevada’s 14 rural and frontier hospitals had a combined 9,297 admissions, 29,199 inpatient days, an average stay of 3.1 days, an average daily census of 79.8, and an occupancy rate of 25.6% (Table 6.13).

• In 2015, rural and frontier hospitals had inpatient operating revenue of $266.9 million or 23.5% of the total patient revenue; the outpatient revenue was $708.2 million or 68.3% of the total patient revenue (Table 6.15).

• For 2015, rural and frontier hospitals had $266.9 million in inpatient revenue and $708.3 million in outpatient revenue totaling $976.9 million in total revenue. Outpatient revenue averaged 68.3% of total revenue (Table 6.15).

• In 2015, after $650.8 million of contractual deductions and adjustments, the net patient revenue for rural and frontier hospitals in Nevada was $371.1 million. Operating expenses were $350.7 million resulting in an operating income of $20.4 million (Table 6.16).

• In 2015, operating income ($20.4 million) increased by $29.6 million in government appropriations and other income (non-patient revenue). The net operating income was $50.1 million for rural and frontier hospitals (Table 6.17).

• In 2015, the operating income per adjusted admission was $571 and the operating income per adjusted inpatient day was $187 (Table 6.18).

• In 2015, net income was $45.0 million for 14 community hospitals in Nevada; the net income per adjusted admission was $1,399 and a net income per adjusted inpatient day was $460 (Table 6.19).

• In 2015, rural and frontier hospitals had an average daily charge per adjusted admission of $5,586 and an average charge per admission of $21,490 (Table 6.20).

• In 2015, 45.0% of inpatient admissions, 36.0% outpatient admissions, and 23.5% of emergency department admissions were Medicare patients in Nevada hospitals (Tables 6.21 through 6.23).

• In 2015, 54.9% of inpatient admissions, 47.0% outpatient admissions, and 34.8% of emergency department admissions were Medicare patients in Nevada hospitals (Tables 6.21 through 6.23).

• In 2015, four of the top five hospital admissions were related to birth outcomes or septicemia in both rural and urban hospitals (Tables 6.24 and 6.25).

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Map 6.1: Nevada Mileage Diagram

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Table 6.1: The Unique Geography of Community Hospitals in Rural and Frontier Nevada — 2017

Hospital — Town/County

Mileage from hospital to —

Nearest Incorporated

Town

Nearest Hospital

Nearest Tertiary Hospital

Office of Rural Health

in Reno

Banner Churchill Community Hospital — Fallon/Churchill 27 56 63 64

Battle Mountain General Hospital — Battle Mountain/Lander 49 54 218 219

Boulder City Hospital — Boulder City/Clark 11 11 11 474

Carson Valley Medical Center — Gardnerville/Douglas 18 24 52 53

Desert View Hospital — Pahrump/Nye 62 62 62 406

Grover C. Dils Medical Center — Caliente/Lincoln 25 96 149 454

Humboldt General Hospital — Winnemucca/Humboldt 54 54 166 167

Incline Village Community Hospital — Incline Village/Washoe 20 27 34 35

Mesa View Hospital — Mesquite/Clark 39 39 39 517

Mt. Grant General Hospital — Hawthorne/Mineral 57 57 123 133

Northeastern Nevada Regional Hospital — Elko/Elko 20 70 230 295

Pershing General Hospital — Lovelock/Pershing 56 56 93 94

South Lyon Medical Center — Yerington/Lyon 46 59 80 81

William Bee Ririe Hospital — Ely/White Pine 118 118 242 320

Rural and Frontier Average 46.3 59.1 118.1 236.7

Source: Nevada Department of Transportation (2016).

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Table 6.2: Number and Type of Licensed Beds in Community Hospitals in Rural and Frontier Nevada — 2017

Hospital

Licensed Beds

Acute Care Beds

Skilled Nursing Beds

Swing Beds

Rehabilitation and Psychiatric

Beds

Banner Churchill Community Hospital 25 0 0 0

Battle Mountain General Hospital 7 18 7 0

Boulder City Hospital* 25 47 25 20

Carson Valley Medical Center 23 0 5 0

Desert View Hospital 25 0 4 0

Grover C. Dils Medical Center 4 16 4 0

Humboldt General Hospital 25 42 2 0

Incline Village Community Hospital* 4 0 0 0

Mesa View Regional Hospital* 25 0 14 0

Mt. Grant General Hospital 11 24 5 0

Northeastern Nevada Regional Hospital 59 0 0 8

Pershing General Hospital 13 25 13 0

South Lyon Medical Center 14 49 14 0

William Bee Ririe Hospital 25 0 10 0

Rural and Frontier — Total 285 221 103 28

Sources: Cost Report Data Resources, LLC (2016). Nevada Rural Hospital Partners (2016). Note: Hospitals marked with an asterisk (*) are Critical Access Hospitals (CAHs) located in urban counties.

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Table 6.3: Number and Per Capita Distribution of Licensed Community Hospital Beds and Skilled Nursing Beds in Nevada by County — 2017

Region/County

Licensed Community Hospital Beds

Licensed Skilled Nursing Beds

Number Number per

1,000 Population

Number Number per

1,000 Population

Number per 1,000

Population Aged 65+

Rural and Frontier

Churchill County 25 1.0 102 4.0 25.7

Douglas County 23 0.5 60 1.2 5.1

Elko County 59 1.1 146 2.7 23.3

Esmeralda County 0 0.0 0 0.0 0.0

Eureka County 0 0.0 0 0.0 0.0

Humboldt County 25 1.5 41 2.5 19.4

Lander County 7 1.2 18 2.9 20.2

Lincoln County 4 0.8 16 3.1 14.8

Lyon County 14 0.3 49 0.3 1.3

Mineral County 11 2.5 24 5.4 25.5

Nye County 25 0.6 0 0.0 0.0

Pershing County 13 1.9 25 3.6 26.2

Storey County 0 0.0 0 0.0 0.0

White Pine County 25 2.5 97 9.5 57.4

Region Subtotal 231 0.8 578 2.0 10.7

Urban Counties

Carson City 220 3.9 339 6.2 32.6

Clark County 3,692 1.8 3,392 1.6 11.7

Washoe County 1,179 2.6 876 2.0 12.9

Region Subtotal 5,091 1.9 4,607 1.8 12.5

Nevada — Total 5,322 1.8 5,185 1.6 12.2

Sources: Cost Report Data Resources, LLC (2016). Nevada Rural Hospital Partners (2016).

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Table 6.4: Community Hospitals in Rural and Frontier Nevada

Hospital Licensed Beds Employees — FY 2015 (FTE)

Annual Payroll — FY 2015 (Dollars)

Average Salary (Dollars)

Banner Churchill Community Hospital 25 232 14,944,099 64,414

Battle Mountain General Hospital 25 111 7,930,616 71,447

Boulder City Hospital 92 190 10,157,419 53,460

Carson Valley Medical Center 23 253 16,067,530 63,508

Desert View Hospital 25 222 12,809,355 57,700

Grover C. Dils Medical Center 20 54 2,766,243 51,227

Humboldt General Hospital 53 221 14,935,601 67,582

Incline Village Community Hospital 4 31 3,465,234 111,782

Mesa View Regional Hospital 25 149 9,558,053 64,148

Mt. Grant General Hospital 35 101 5,147,805 50,968

Northeastern Nevada Regional Hospital 67 268 18,701,688 69,782

Pershing General Hospital 38 82 4,273,718 52,119

South Lyon Medical Center 63 158 6,412,810 40,587

William Bee Ririe Hospital 25 177 13,740,541 77,630

Rural and Frontier – Total 520 2,249 140,910,712 62,655

Sources: Cost Report Data Resources, LLC (2016). Note: Licensed beds include acute, skilled nursing and psychiatric rehabilitation beds.

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Table 6.5: Community Hospitals in Urban Nevada

Hospital Licensed Beds Employees — FY 2015 (FTE)


Average Salary (Dollars)

Carson City

Carson Tahoe Regional Medical Center 205 1,078 76,402,982 70,875

Sierra Surgery Hospital 15 101 7,919,512 78,411

Clark County

Centennial Hills Hospital Medical Center 190 827 58,885,175 71,203

Desert Springs Hospital Medical Center 293 1,096 73,249,430 66,833

Mountain View Hospital 336 1,352 123,285,733 91,188

North Vista Hospital 172 560 30,851,222 55,091

St. Rose Dominican Hospital, Rose de Lima Campus 110 722 61,088,291 84,610

St. Rose Dominican Hospital, San Martin Campus 147 648 63,561,750 98,089

St. Rose Dominican Hospital, Siena Campus 230 1,418 137,110,074 96,693

Southern Hills Hospital and Medical Center 134 612 50,178,330 81,991

Spring Valley Hospital Medical Center 237 1,099 79,033,479 71,914

Summerlin Hospital Medical Center 454 1,591 112,913,495 70,970

Sunrise Hospital and Medical Center 608 2,702 223,666,695 82,778

University Medical Center of Southern Nevada 499 3,263 236,400,489 72,449

Valley Hospital Medical Center 282 1,288 86,662,888 67,285

Washoe County

Northern Nevada Medical Center 108 404 26,371,607 65,276

Renown Regional Medical Center 619 2,692 165,740,866 61,568

Renown South Meadows Medical Center 138 524 32,261,166 61,567

Saint Mary’s Regional Medical Center 252 1,490 101,839,256 68,348

Urban – Total 5,029 23,467 1,747,422,440 74,463

Sources: Cost Report Data Resources, LLC (2016).

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Table 6.6: Employment Impact of Community Hospitals in Nevada

Hospital

Employment Impact of Community Hospitals (Number of Jobs)

Employees — FY 2015 (FTE)

Type II Employment

Multiplier

Secondary Employment

Impact

Total Employment

Impact

Rural and Frontier

Banner Churchill Community Hospital 232 1.84 196 428

Battle Mountain General Hospital 111 1.23 26 137

Boulder City Hospital 190 1.97 183 373

Carson Valley Medical Center 253 1.58 146 399

Desert View Hospital 222 1.42 94 316

Grover C. Dils Medical Center 54 1.33 18 72

Humboldt General Hospital 221 1.44 98 319

Incline Village Community Hospital 31 1.94 29 60

Mesa View Regional Hospital 149 1.97 144 293

Mt. Grant General Hospital 101 1.34 34 135

Northeastern Nevada Regional Hospital 268 1.45 120 388

Pershing General Hospital 82 1.13 10 92

South Lyon Medical Center 158 1.35 56 214

William Bee Ririe Hospital 177 1.39 68 245

Region Subtotal 2,249 1.54 1,222 3,471

Urban

Carson City Hospitals 1,179 1.62 731 1,910

Clark County Hospitals 17,179 1.97 16,582 33,761

Washoe County Hospitals 5,110 1.94 4,782 9,892

Region Subtotal 23,468 1.94 22,093 45,561

Nevada — Total 25,717 1.93 23,900 49,617

Sources: Office of Statewide Initiatives analysis of data from the Nevada Department of Employment, Training, and Rehabilitation (2016). Cost Report Data Resources, LLC (2016). University Center for Economic Development (2016).

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Table 6.7: Payroll Impact of Community Hospitals in Nevada

Hospital Payroll Impact of Community Hospitals (Dollars)


Type II Payroll Multiplier

Secondary Payroll Impact

Total Payroll Impact

Rural and Frontier

Banner Churchill Community Hospital 14,944,099 1.25 3,752,822 18,696,921

Battle Mountain General Hospital 7,930,616 1.07 549,552 8,480,168

Boulder City Hospital 10,157,419 1.48 4,894,149 15,051,568

Carson Valley Medical Center 16,067,530 1.28 4,498,812 20,566,342

Desert View Hospital 12,809,355 1.20 2,503,588 15,312,943

Grover C. Dils Medical Center 2,766,243 1.07 187,012 2,953,255

Humboldt General Hospital 14,935,601 1.17 2,559,917 17,495,518

Incline Village Community Hospital 3,465,234 1.58 2,004,721 5,469,955

Mesa View Regional Hospital 9,558,053 1.48 4,605,357 14,163,410

Mt. Grant General Hospital 5,147,805 1.08 405,029 5,552,834

Northeastern Nevada Regional Hospital 18,701,688 1.29 5,423,920 24,125,608

Pershing General Hospital 4,273,718 1.05 199,548 4,473,266

South Lyon Medical Center 6,412,810 1.21 1,355,065 7,767,875

William Bee Ririe Hospital 13,740,541 1.14 1,872,575 15,613,116

Region Subtotal 140,910,712 1.25 34,812,068 175,722,780

Urban

Carson City Hospitals 84,322,494 1.32 27,120,391 111,442,885

Clark County Hospitals 1,336,887,051 1.48 644,152,288 1,981,039,339

Washoe County Hospitals 326,212,895 1.58 188,721,989 514,934,884

Region Subtotal 1,747,422,440 1.49 861,025,750 2,608,448,190

Nevada – Total 1,888,333,152 1.49 921,287,112 2,809,620,264


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Table 6.8: Employment Impact of the Health Sector in Nevada by County — 2016

Region/County

Employment Impact of the Health Sector (Number of Jobs)

Health Sector Employment

Type II Employment

Multiplier

Secondary Employment

Impact

Total Employment

Impact

Rural and Frontier

Churchill County 953 1.51 488 1,441

Douglas County 1,433 1.44 628 2,061

Elko County 1,536 1.33 514 2,050

Esmeralda County 0 0.00 0 0

Eureka County 17 1.06 1 18

Humboldt County 466 1.21 100 566

Lander County 185 1.19 22 207

Lincoln County 230 1.11 25 255

Lyon County 482 1.24 116 598

Mineral County 170 1.21 35 205

Nye County 810 1.30 244 1,054

Pershing County 124 1.12 15 139

Storey County 33 1.06 2 35

White Pine County 251 1.18 46 297

Region Subtotal 6,640 1.34 2,236 8,926

Urban

Carson City 3,675 1.53 1,955 5,630

Clark County 76,582 1.66 50,787 127,369

Washoe County 23,945 1.68 16,177 40,122

Region Subtotal 101,781 1.70 68,919 173,121

Nevada — Total 108,480 1.66 71,676 180,156


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Table 6.9: Payroll Impact of the Health Sector in Nevada by County — 2016

Region/County

Payroll Impact of the Health Sector (Dollars)

Health Sector Payroll

Type II Income

Multiplier

Secondary Payroll Impact

Total Payroll Impact

Rural and Frontier

Churchill County 40,330,224 1.27 11,008,464 51,338,688

Douglas County 71,849,006 1.24 17,183,311 89,032,317

Elko County 70,738,731 1.25 17,519,009 88,257,740

Esmeralda County 0 0.00 0 0

Eureka County 596,298 1.03 16,198 612,496

Humboldt County 21,861,692 1.17 3,755,252 25,616,944

Lander County 8,792,279 1.10 823,720 9,615,999

Lincoln County 8,935,109 1.10 837,101 9,772,210

Lyon County 17,529,329 1.16 2,754,418 20,283,747

Mineral County 6,932,663 1.15 1,048,590 7,981,253

Nye County 34,897,630 1.17 5,940,991 40,838,621

Pershing County 4,533,096 1.05 223,413 4,756,509

Storey County 1,192,597 1.07 85,104 1,277,701

White Pine County 16,425,085 1.14 2,250,525 18,675,610

Region Subtotal 304,017,441 1.21 63,446,096 368,059,835

Urban

Carson City 204,291,004 1.27 55,762,900 260,053,904

Clark County 4,719,879,092 1.44 2,073,942,782 6,793,821,874

Washoe County 1,322,896,607 1.48 635,003,369 1,957,899,976

Region Subtotal 6,247,066,703 1.44 2,764,709,051 9,011,775,754

Nevada — Total 6,552,544,131 1.43 2,828,717,701 9,381,261,832


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Table 6.10: Ownership, Tax Status, and Service Area of Community Hospitals in Rural and Frontier Nevada — 2017

Hospital Ownership — Tax Status Estimated Service Area Population — Service Area

Rural Health Clinic

Banner Churchill Community Hospital Not-for-profit (501c3) / Private — Banner Health System

55,000 / Fallon, Fernley, Churchill County, Northern Lyon County No

Battle Mountain General Hospital Not-for-profit / Public — Lander County Hospital District

6,000 / Battle Mountain, Lander County, Northern Eureka County Yes (2)

Boulder City Hospital Not-for-profit (501c3) / Private — Boulder City Hospital, Inc.

25,000 / Boulder City, Henderson, Searchlight, Rural Clark County No

Carson Valley Medical Center Not-for-profit (501c3) / Private — Barton Healthcare and Renown Health

50,000 / Minden, Gardnerville, Douglas County, Bordering California Counties

Yes (2)

Desert View Hospital For-profit / Private — Universal Health Services

40,000 / Pahrump, Southern Nye County No

Grover C. Dils Medical Center Not-for-profit / Public — Lincoln County Hospital District

5,000 / Caliente, Panaca, Pioche, Alamo, Lincoln County Yes

Humboldt General Hospital Not-for-profit / Public — Humboldt County Hospital District

18,000 / Winnemucca, Humboldt County Yes

Incline Village Community Hospital Not-for-profit / Private — Tahoe Forest Hospital District

10,000 / Incline Village, Washoe County, North Lake Tahoe Area No

Mesa View Regional Hospital For-profit / Private — Community Health Systems

20,000 / Mesquite, Moapa, Rural Clark County No

Mt. Grant General Hospital Not-for-profit / Public — Mineral County Hospital District

5,000 / Hawthorne, Schurz, Mineral County Yes

Northeastern Nevada Regional Hospital For-profit / Private — Province Health Care Corporation

52,000 / Elko, Carlin, Wells, Elko County No

Pershing General Hospital Not-for-profit / Public — Pershing County Hospital District 7,000 / Lovelock, Pershing County Yes

South Lyon Medical Center Not-for-profit (501c3) / Non-governmental — Receives Lyon County Tax Support

5,000 / Yerington, Wellington, Smith Valley, Southern Lyon County Yes (3)

William Bee Ririe Hospital Not-for-profit / Public — White Pine County Hospital District

10,000 / Ely, Ruth, White Pine County, Western Eureka County Yes

Rural and Frontier — Total 11 Not-for-profit / 3 For-profit Approximately 300,000 residents of rural and frontier Nevada 12

Sources: Nevada Rural Hospital Partners (2016). Nevada State Demographer’s Office (2016).

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Table 6.11: Federally Qualified Health Centers (FQHCs) in Rural and Frontier Nevada — 2017

Community Health Center / County Estimated Service Area Population — Service Area

Amargosa Valley Medical Clinic — Nye County 1,500 / Amargosa Valley, Southern Nye County, Bordering California Counties

Austin Medical Clinic — Lander County 500 / Austin, Southern Lander County

Carlin Community Health Center — Elko County 2,500 / Carlin, Western Elko County

Crescent Valley Medical Center — Eureka County 500 / Crescent Valley, Northern Eureka County

Elko Medical and Dental Clinic — Elko County 45,000 / Elko, Central Elko County

Eureka Medical Clinic — Eureka County 500 / Eureka, Eureka County

Jackpot Community Health Center — Elko County 5,000 / Jackpot, Northern Elko County, Southern Idaho Counties

Virginia City Community Health Center — Storey County 1,500 / Gold Hill, Virginia City, Storey County

Wendover Community Health Center — Elko County 5,000 / West Wendover, Eastern Elko County, East Wendover (Utah)

Rural and Frontier — Total Approximately 65,000 residents in rural and frontier counties of Nevada

Sources: Nevada Health Centers (2016). Nevada State Demographer’s Office (2016).

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Table 6.12: Tribal Medical Clinics and Health Centers in Rural and Frontier Nevada — 2017

Tribal Clinic or Health Center Service Unit / Tribe or Colony Estimated Tribal Population — Clinic or Health Center Service Area

Battle Mountain Health Center Elko / Shoshone / Battle Mountain Band 550 / Humboldt, Lander Counties

Duck Valley Health Center Elko / Duck Valley Shoshone-Paiute 2,000 / Northern Elko County, Owyhee County (ID)

Duckwater Health Department Elko / Duckwater Shoshone 250 / Nye County

Ely Shoshone Tribal Clinic — Newe Medical Clinic Elko / Ely Shoshone 450 / Eureka, White Pine Counties

Fallon Tribal Health Clinic Schurz / Fallon Paiute-Shoshone, Lovelock Paiute, Summit Lake Paiute

2,500 / Churchill, Humboldt, Lander, Lyon, Nye, Pershing Counties

Fort McDermitt IHS Health Station Schurz / Fort McDermitt Paiute-Shoshone

1,000 / Northern Humboldt County, Malheur County (OR)

Goshute Indian Health Clinic Elko / Confederated Tribes of the Goshute Reservation

400 / Eastern Elko County, Juab County (UT)

Moapa Tribal Clinic Schurz / Moapa Band of Paiute 1,000 / Lincoln, Nye, Clark Counties

Pyramid Lake Tribal Health Clinic Schurz / Pyramid Lake Paiute 3,000 / Lyon, Washoe Counties

Southern Bands Health Center Elko / Te-Moak Western Shoshone — Elko, South Fork, Wells, Battle Mountain Bands

2,000 / Elko, Eureka, Lander Counties, Tooele County (UT)

Walker River Tribal Health Center Schurz / Timbisha Shoshone, Walker River Paiute, Yomba Shoshone 1,500 / Esmeralda, Mineral, Nye Counties

Washoe Tribal Health Center Schurz / Washoe Tribe of Nevada and California — Carson, Dresslerville, Stewart, Woodfords Colonies

3,000 / Carson City, Douglas, Lyon, Storey Counties, Alpine County (CA)

Yerington Paiute Tribal Health Clinic Schurz / Yerington Paiute 750 / Lyon County

Sources: Phoenix Area Indian Health Service (2016). Nevada State Demographer’s Office (2016).

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Table 6.13: Utilization Trends in Rural and Frontier Hospitals in Nevada

Hospital

Utilization — FY 2015

Admissions Inpatient Days

Average Length of

Stay (Days)

Average Daily Census

Occupancy Rate

Banner Churchill Community Hospital 1,577 4,969 3.2 13.6 54.5

Battle Mountain General Hospital 27 66 2.4 0.2 0.7

Boulder City Hospital 225 1,224 5.4 3.4 3.6

Carson Valley Medical Center 911 2,609 2.9 7.1 31.1

Desert View Hospital 1,394 4,419 3.2 12.1 48.4

Grover C. Dils Medical Center 93 301 3.2 0.8 4.1

Humboldt General Hospital 1,092 2,861 2.6 7.8 11.7

Incline Village Community Hospital 8 11 1.4 0.0 0.8

Mesa View Hospital 720 2,067 2.9 5.7 22.7

Mt. Grant General Hospital 395 1,506 3.8 4.1 11.8

Northeastern Nevada Regional Hospital 2,403 7,698 3.2 21.1 35.7

Pershing General Hospital 29 65 2.2 0.2 0.5

South Lyon Medical Center 77 272 3.5 0.7 1.2

William Bee Ririe Hospital 346 1,131 3.3 3.1 12.4

Rural and Frontier — Total 9,297 29,199 3.1 79.8 25.6

Source: Cost Report Data Resources, LLC (2016).

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Table 6.14: Admissions and Inpatient Days in Rural and Frontier Hospitals in Nevada

Hospital Admissions — FY 2015 Inpatient Days — FY 2015

Number Adjusted Number of Admissions Number Adjusted Number

of Inpatient Days

Banner Churchill Community Hospital 1,577 5,394 4,969 16,997

Battle Mountain General Hospital 27 182 66 445

Boulder City Hospital 225 482 1,224 2,620

Carson Valley Medical Center 911 5,126 2,609 14,680

Desert View Hospital 1,394 7,419 4,419 23,517

Grover C. Dils Medical Center 93 220 301 713

Humboldt General Hospital 1,092 2,968 2,861 7,776

Incline Village Community Hospital 8 935 11 1,286

Mesa View Hospital 720 3,277 2,067 9,409

Mt. Grant General Hospital 395 942 1,506 3,591

Northeastern Nevada Regional Hospital 2,403 6,336 7,698 20,298

Pershing General Hospital 65 286 29 127

South Lyon Medical Center 77 353 272 1,247

William Bee Ririe Hospital 346 1,845 1,131 6,031

Rural and Frontier — Total 9,333 35,765 29,163 108,737


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Table 6.15: Total Patient Revenue in Rural and Frontier Hospitals in Nevada

Hospital Total Patient Revenue (Thousands of Dollars) — FY 2015

Inpatient Percent of Total Patient Revenue Outpatient Percent of Total

Patient Revenue Total Patient

Revenue

Banner Churchill Community Hospital 34,067 29.2 82,466 70.8 116,534

Battle Mountain General Hospital 1,726 14.8 9,904 85.2 11,630

Boulder City Hospital 27,194 46.7 31,022 53.3 58,216

Carson Valley Medical Center 26,771 17.8 123,861 82.2 150,632

Desert View Hospital 32,448 18.8 140,234 81.2 172,681

Grover C. Dils Medical Center 2,504 42.2 3,423 57.8 5,927

Humboldt General Hospital 27,106 36.8 46,569 63.2 73,675

Incline Village Community Hospital 127 0.9 14,671 99.1 14,798

Mesa View Hospital 16,061 22.0 57,047 78.0 73,107

Mt. Grant General Hospital 8,167 41.9 11,307 58.1 19,474

Northeastern Nevada Regional Hospital 76,899 37.9 125,867 62.1 202,766

Pershing General Hospital 2,625 22.8 8,909 77.2 11,534

South Lyon Medical Center 4,115 21.8 14,757 78.2 18,872

William Bee Ririe Hospital 8,823 18.8 38,228 81.2 47,051

Rural and Frontier — Total 266,908 23.5 708,265 68.3 976,898


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Table 6.16: Operating Income in Rural and Frontier Hospitals in Nevada

Hospital Operating Income (Thousands of Dollars) — FY 2015

Total Patient Revenue

Deductions and Adjustments

Net Patient Revenue

Operating Expense

Operating Income

Banner Churchill Community Hospital 116,534 76,274 40,260 35,801 4,459

Battle Mountain General Hospital 11,630 4,327 7,303 14,819 7,516

Boulder City Hospital 58,216 33,499 24,717 24,392 325

Carson Valley Medical Center 150,632 103,936 46,696 44,506 2,190

Desert View Hospital 172,681 136,222 36,459 28,900 7,559

Grover C. Dils Medical Center 5,927 1,736 4,191 5,115 -924

Humboldt General Hospital 73,675 34,283 39,392 38,854 538

Incline Village Community Hospital 14,798 5,574 9,224 9,384 -160

Mesa View Hospital 73,107 47,131 25,977 25,724 253

Mt. Grant General Hospital 19,474 9,160 10,314 11,476 -1,162

Northeastern Nevada Regional Hospital 202,766 120,901 81,865 62,325 19,540

Pershing General Hospital 11,534 3,206 8,328 9,478 -1,150

South Lyon Medical Center 18,872 9,038 9,834 12,252 -2,418

William Bee Ririe Hospital 47,051 20,488 26,563 27,676 -1,113

Rural and Frontier — Total 976,898 605,776 371,122 350,702 20,420


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Table 6.17: Net Income in Rural and Frontier Hospitals in Nevada

Hospital Net Income (Thousands of Dollars) — FY 2015

Operating Income

Government Appropriations Other Income Total Non-

Patient Revenue Net Income or

(Loss)

Banner Churchill Community Hospital 4,459 0 550 549 5,008

Battle Mountain General Hospital 7,516 6,762 1,057 7,818 293

Boulder City Hospital 325 0 337 337 662

Carson Valley Medical Center 2,190 0 1,404 1,404 3,594

Desert View Hospital 7,559 0 100 100 7,658

Grover C. Dils Medical Center -924 917 787 1,704 776

Humboldt General Hospital 538 7,083 843 7,926 8,463

Incline Village Community Hospital -160 0 881 881 721

Mesa View Hospital 253 0 622 622 875

Mt. Grant General Hospital -1,162 374 276 650 (513)

Northeastern Nevada Regional Hospital 19,540 0 768 768 20,308

Pershing General Hospital -1,150 0 1,853 1,853 712

South Lyon Medical Center -2,418 0 0 1,826 (591)

William Bee Ririe Hospital -1,113 1,898 1,292 3,190 2,076

Rural and Frontier — Total 20,420 17,034 10,769 29,629 50,057


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Table 6.18: Operating Income per Adjusted Admission and Adjusted Inpatient Day in Rural and Frontier Hospitals in Nevada

Hospital

Operating Income Metrics (Dollars) — FY 2015

Operating Income

Adjusted Admissions

Operating Income per

Adjusted Admission

Adjusted Inpatient Days

Operating Income per

Adjusted Inpatient Day

Banner Churchill Community Hospital 4,458,405 5,394 826 16,997 262

Battle Mountain General Hospital -7,515,557 182 -41,313 445 -16,901

Boulder City Hospital 325,283 482 675 2,620 124

Carson Valley Medical Center 2,189,631 5,126 427 14,680 149

Desert View Hospital 7,558,652 7,419 1,018 23,517 321

Grover C. Dils Medical Center -924,125 220 -4,197 713 -1,297

Humboldt General Hospital 537,751 2,968 181 7,776 69

Incline Village Community Hospital -160,351 935 -171 1,286 -125

Mesa View Hospital 252,727 3,277 77 9,409 27

Mt. Grant General Hospital 1,162,734 942 -1,234 3,591 -323

Northeastern Nevada Regional Hospital 19,540,466 6,336 3,084 20,298 963

Pershing General Hospital -1,140,927 286 -3,995 127 -8,954

South Lyon Medical Center -2,417,598 353 -6,847 1,247 -1,938

William Bee Ririe Hospital -1,113,402 1,845 603 6,031 -184

Rural and Frontier — Total 20,428,221 35,765 571 108,738 187


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Table 6.19: Net Income per Adjusted Admission and Adjusted Inpatient Day in Rural and Frontier Hospitals in Nevada

Hospital Net Income Metrics (Dollars) — FY 2015

Net Income Adjusted Admissions

Net Income per Adjusted

Admission

Adjusted Inpatient Days

Net Income per Adjusted

Inpatient Day

Banner Churchill Community Hospital 5,007,767 5,394 928 16,997 295

Battle Mountain General Hospital 293,320 182 1,611 445 659

Boulder City Hospital 662,330 482 1,374 2,620 253

Carson Valley Medical Center 3,593,543 5,126 701 14,680 245

Desert View Hospital 7,658,419 7,419 1,032 23,517 326

Grover C. Dils Medical Center 775,824 220 3,525 713 1,089

Humboldt General Hospital 8,463,354 2,968 2,851 7,776 1,088

Incline Village Community Hospital 720,728 935 771 1,286 561

Mesa View Hospital 874,903 3,277 267 9,409 93

Mt. Grant General Hospital -512,522 942 -545 3,591 -143

Northeastern Nevada Regional Hospital 20,307,967 6,336 3,205 20,298 1,000

Pershing General Hospital 703,221 286 2,462 127 5,517

South Lyon Medical Center -591,238 353 -1,674 1,247 -474

William Bee Ririe Hospital 2,076,273 1,845 1,125 6,031 344

Rural and Frontier — Total 45,026,122 35,765 1,399 108,737 460


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Table 6.20: Inpatient Billed Charges in Rural and Frontier Hospitals in Nevada

Hospital Inpatient Billed Charges (Dollars) — FY 2015

Total Charges Average Daily Charges per

Adjusted Admission

Average Charges per Admission

Banner Churchill Community Hospital 33,713,705 6,250 21,378

Battle Mountain General Hospital 503,001 2,764 18,630

Boulder City Hospital 6,300,123 13,071 28,001

Carson Valley Medical Center 25,624,400 4,999 28,128

Desert View Hospital 17,664,013 2,381 12,671

Grover C. Dils Medical Center 1,099,706 4,999 11,825

Humboldt General Hospital 18,476,497 6,225 16,920

Incline Village Community Hospital 40,927 44 5,116

Mesa View Hospital 17,079,453 5,212 23,721

Mt. Grant General Hospital 1,618,620 1,718 4,098

Northeastern Nevada Regional Hospital 67,777,595 10,697 28,205

Pershing General Hospital 767,764 2,684 26,475

South Lyon Medical Center 570,942 1,617 7,415

William Bee Ririe Hospital 8,560,183 4,640 24,740

Rural and Frontier — Total 199,796,929 5,586 21,490

Source: INTELLIMED International (2016).

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Table 6.21: Inpatient Billed Charges by Type in Rural and Frontier Hospitals in Nevada

Hospital Inpatient Admissions (Percent) — FY 2015

Medicare Medicaid Private/

Commercial Insurer

Self Pay Other

Banner Churchill Community Hospital 54.1 21.1 15.2 3.6 6.1

Battle Mountain General Hospital 42.8 11.3 42.6 0.0 3.3

Boulder City Hospital 61.9 16.9 6.8 1.3 13.1

Carson Valley Medical Center 69.0 12.3 14.4 2.1 2.2

Desert View Hospital 74.9 8.3 6.8 3.2 6.8

Grover C. Dils Medical Center 82.1 5.9 7.3 4.0 0.6

Humboldt General Hospital 45.0 22.2 24.1 6.5 2.1

Incline Village Community Hospital 0.0 38.0 62.0 0.0 0.0

Mesa View Hospital 60.6 17.4 18.9 1.1 2.0

Mt. Grant General Hospital 79.8 9.1 6.7 2.9 1.4

Northeastern Nevada Regional Hospital 45.2 12.5 34.3 4.3 3.7

Pershing General Hospital 81.4 9.2 8.1 0.4 0.9

South Lyon Medical Center 81.7 6.1 12.3 0.0 0.0

William Bee Ririe Hospital 43.9 17.5 30.7 3.9 4.1

Rural and Frontier — Average 54.9 15.1 22.3 3.6 4.1

Urban — Average 44.3 21.7 28.0 2.4 3.6

Nevada — Average 45.0 21.2 27.5 2.3 3.9

Sources: INTELLIMED International (2016).

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Table 6.22: Outpatient Billed Charges in Rural and Frontier Hospitals in Nevada

Hospital Outpatient Encounters (Percent) — FY 2015


Commercial Insurer

Self Pay Other
















Urban — Average 38.4 16.0 40.8 1.5 3.3

Nevada — Average 36.0 14.9 42.3 1.5 5.3


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Table 6.23: Emergency Department Billed Charges in Rural and Frontier Hospitals in Nevada

Hospital Emergency Department Admissions (Percent) — FY 2015


Commercial Insurer

Self Pay Other
















Urban — Average 22.9 29.2 34.0 9.6 4.3

Nevada — Average 23.5 28.9 33.6 9.5 4.5


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Table 6.24: Top Twenty Types of Admissions in Community Hospitals in Rural and Frontier Nevada — 2015

DRG Type of Admission (Diagnostically Related Group)

Utilization and Charges

Number of Admissions

Total Patient Days

Average Charge per Admission (Dollars)

795 Normal Newborn 975 1,504 2,617

775 Vaginal Delivery W/O Complicating Diagnoses 769 1,113 10,611

194 Simple Pneumonia and Pleurisy W CC 335 1,226 26,969

766 Cesarean Section W/O CC/MCC 270 665 19,682

871 Septicemia or Severe Sepsis W/O MV 96+ Hours W MCC 258 1,140 32,073

392 Esophagitis, Gastroenteritis and Misc Digestive Disorders W/O MCC 253 684 17,644

470 Major Joint Replacement or Reattachment of Lower Extremity W/O MCC 235 701 64,780

603 Cellulitis W/O MCC 213 797 20,525

195 Simple Pneumonia and Pleurisy W/O CC/MCC 210 654 16,883

794 Neonate with Other Significant Problems 206 381 3,549

690 Kidney and Urinary Tract Infections W/O MCC 204 719 18,841

872 Septicemia or Severe Sepsis W/O MV 96+ Hours W/O MCC 180 704 24,355

292 Heart Failure and Shock W CC 161 565 24,773

192 Chronic Obstructive Pulmonary Disease W/O CC/MCC 127 426 20,790

641 Nutritional and Misc Metabolic Disorders W/O MCC 124 411 16,845

190 Chronic Obstructive Pulmonary Disease with MCC 119 1,092 28,436

191 Chronic Obstructive Pulmonary Disease W CC 119 427 24,977

193 Simple Pneumonia and Pleurisy with MCC 108 493 31,951

885 Psychoses 98 1,094 14,855

765 Cesarean Section with CC/MCC 91 239 22,145


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Table 6.25: Top Twenty Types of Admissions in Community Hospitals in Urban Nevada — 2015

DRG Type of Admission (Diagnostically Related Group)

Utilization and Charges

Number of Admissions

Total Patient

Days

Average Charge per Admission (Dollars)

795 Normal Newborn 21,372 37,477 3,509

775 Vaginal Delivery W/O Complicating Diagnoses 17,983 32,793 17,434

871 Septicemia or Severe Sepsis W/O MV 96+ Hours with MCC 8,489 56,184 91,993

766 Cesarean Section without CC/MCC 7,197 19,374 27,933

470 Major Joint Replacement or Reattachment of Lower Extremity W/O MCC 7,163 21,379 97,646

794 Neonate with Other Significant Problems 6,884 16,880 9,520

885 Psychoses 5,078 44,188 33,285

392 Esophagitis, Gastroenteritis and Misc Digestive Disorders W/O MCC 4,677 12,763 38,037

765 Cesarean Section with CC/MCC 4,350 16,620 37,286

603 Cellulitis without MCC 3,327 12,136 40,805

945 Rehabilitation with CC/MCC 3,300 50,181 106,467

872 Septicemia or Severe Sepsis W/O MV 96+ Hours W/O MCC 3,274 14,359 50,115

683 Renal Failure with CC 2,734 10,721 50,161

291 Heart Failure and Shock with MCC 2,680 15,430 76,266

690 Kidney and Urinary Tract Infections W/O MCC 2,633 8,426 38,494

189 Pulmonary Edema and Respiratory Failure 2,447 11,091 60,702

193 Simple Pneumonia and Pleurisy with MCC 2,437 13,177 68,579

774 Vaginal Delivery with Complicating Diagnoses 2,387 5,559 20,872

460 Spinal Fusion Except Cervical W/O MCC 2,345 7,486 164,618

292 Heart Failure and Shock with CC 2,319 8,708 47,822


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